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UMass Center for Clinical and Translational Science

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Article Preprint


Infectious Disease | Mental and Social Health | Psychiatry | Psychiatry and Psychology | Translational Medical Research | Virus Diseases


Background COVID-19 has been shown to increase the risk of adverse mental health consequences. A recent electronic health record (EHR)-based observational study showed an almost two-fold increased risk of new-onset mental illness in the first 90 days following a diagnosis of acute COVID-19.

Methods We used the National COVID Cohort Collaborative, a harmonized EHR repository with 2,965,506 COVID-19 positive patients, and compared cohorts of COVID-19 patients with comparable controls. Patients were propensity score-matched to control for confounding factors. We estimated the hazard ratio (COVID-19:control) for new-onset of mental illness for the first year following diagnosis. We additionally estimated the change in risk for new-onset mental illness between the periods of 21-120 and 121-365 days following infection.

Findings We find a significant increase in incidence of new-onset mental disorders in the period of 21-120 days following COVID-19 (3.8%, 3.6-4.0) compared to patients with respiratory tract infections (3%, 2.8-3.2). We further show that the risk for new-onset mental illness decreases over the first year following COVID-19 diagnosis compared to other respiratory tract infections and demonstrate a reduced (non-significant) hazard ratio over the period of 121-365 days following diagnosis. Similar findings are seen for new-onset anxiety disorders but not for mood disorders.

Interpretation Patients who have recovered from COVID-19 are at an increased risk for developing new-onset mental illness, especially anxiety disorders. This risk is most prominent in the first 120 days following infection.

Funding National Center for Advancing Translational Sciences (NCATS).


Epidemiology, COVID-19, mental illness, mental health

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medRxiv 2021.11.30.21267071; doi: Link to preprint on medRxiv.

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This article is a preprint. Preprints are preliminary reports of work that have not been certified by peer review.

The UMass Center for Clinical and Translational Science (UMCCTS), UL1TR001453, helped fund this study.

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.